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General NPI Number Information
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NPI Number | 1902572381
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Entity Type | Individual
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Provider Name | SARAH MOXON LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 166 SANTA CLARA AVE STE 203-204
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City | OAKLAND
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State | CA
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Zip | 94610-1323
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Country | US
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Telephone | 510-823-2455
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Fax |
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Provider Business Mailing Address
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Address Line | 30970 HUNTWOOD AVE
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City | HAYWARD
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State | CA
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Zip | 94544-7035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCSW84359
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License Number State | CA
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